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- W2363621529 abstract "Objective To investigate the effects of acute hypervolemie hemodilution(AHH)combinedwith bypotension(CH)on hemodynamies and tissue perfusion and to evaluate the safety of the technique.MethodsForty-eight ASA Ⅰ-Ⅱ patients of both sexes(28 male,20 female)aged 41-63 yr weighing 47-85kg undergoingelective orthopedic operations were randomly divided into 4 group with 12 patients in each group:A control group;B CH group;C AHH group and D CH+AHH group.The patients were premedicated with oral diazepam 10 mgand intramuscular atropine 0.5 mg.Anesthesia was induced with midazolam 0.04 mg·kg~(-1),fentanyl 4μg·kg~(-1),propefol 1.5-2.0 mg·kg~(-1) and vecuronium 0.1 mg·kg~(-1) and maintained with inhalation of 1%-3 % isoflurane and50% N_2O in O_2 supplemented with intermittent i.v.boluses of vecaronium.The patients were mechanicallyventilated after tracheal intubation(V_T=8-10 ml·kg~(-1),RR 12 bpm).Radial artery and right internal jugular veinwere cannulated.The CVP catheter was inserted into right atrium and the blood obtained from right atrium was usedto replace mixed venous blood.ECG,MAP,HR,CVP,SpO_2 and urine output were continuously monitored duringoperation.Controlled hypotension was induced with sodium nitroprusside(NTP)at 0.1-2 μg·kg~(-1)·min~(-1) andMAP was maintained at 70% of the baseline MAP during operation.NTP infusion was terminated 30 min beforethe end of surgery.AHH was induced with 6% HES 15 ml·kg~(-1) at 50 ml·min~(-1) after induction of anesthesia andbefore skin incision.Blood samples were taken from radial artery and right atrium before AHH(T_0,baseline),immediately after AHH or before CH(T_1),1h after AHH or 40 min after start of CH(T_2),at the end of surgeryor 30 rain after termination of NTG infusion(T_3)and 24h after surgery(T_4)for blood gas analysis and calculationof oxygen extraction ratio(ERO_2).Blood volume was maintained with infusion of colloid and lactated Ringer'ssolution.The amount of blood loss and blood transfusion were recorded.Hb was maintained above 70 g·L~(-1)Results CVP increassd significantly after AHH in group C and D as compared to baseline(P0.01);HRincreased significantly in group B after CH(P0.01).The blood loss in group B and D was significantly lessthan that in group A(P0.01).Urine output was significantly increased in group C and D compared with groupA and B(P0.05).There was no significant difference in lactate,SvO_2,K~+ and Na~+ among the four groups(P0.05).Conclusion AHH combined with CH can maintain stable hemodynamics,decrease blood loss andblood transfusion during operation and maintain the balance between oxygen delivery and oxygen consumption." @default.
- W2363621529 created "2016-06-24" @default.
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- W2363621529 date "2004-01-01" @default.
- W2363621529 modified "2023-09-25" @default.
- W2363621529 title "The feasibility of acute hypervolemic hemodilution combined with controlled hypotension in patients undergoing elective orthopedic operations" @default.
- W2363621529 hasPublicationYear "2004" @default.
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